Hospital Services Report

March quarter 2003 Notes

This document contains the most up-to-date information available at the time of preparation.

This Hospital Services Report is available on the Department of Human Services Internet site located at: http://www.health.vic.gov.au/hsr/index.htm

Design and production by Department of Human Services, Melbourne, Victoria.

March 2003

ii Contents

Introduction 1 1. Patients waiting for residential aged care placement 3 2. Hospital admitted patient activity 5 3. Access to emergency services 7 4. Access to critical care services 17 5. Access to elective surgery 19 6. Private health insurance 31 7. Glossary 33

iii

Introduction

Consumers, health care providers and government all need information on the quality of health services. Public access to information assists consumers to understand the health care system, it assists providers of health services in planning and increases the accountability of the Department of Human Services to the people in the state of Victoria, Australia.

The Hospital Services Report was introduced in 1995. This edition includes data for the March quarter 2003, which covers the months of January, February and March.

The information included in this report is often requested from the Department. Since technical information of this nature is very difficult to interpret, each graph and table needs to be carefully considered in the context of the complexity of the health care system. Department staff, hospital staff, general practitioners and other health care professionals may be able to assist you to interpret this report.

A number of graphs and tables refer to major metropolitan hospitals. A list of the major metropolitan hospitals can be found in the glossary.

1. Patients waiting for residential aged care placement

How many patients are waiting for residential aged care placements?

Figure 1.1 Number of acute and sub acute patients waiting for residential aged care placement 1 2

Patients 800

700 621 565

600 532 Interim Care 500 207 Sub Acute 176 Acute 194 400

300 254 254 211 200

100 135 127 160 0 Sep-02 Dec-02 Mar-03

1 Hospitals reporting sub acute are Angliss, Anne Caudle, Bundoora Extended Care, Bethlehem, Broadmeadows, Caritas Christi, Caulfield General, Dandenong, Goulburn Valley, Grace McKellar, Hampton (before closure in December 2002), Kingston, Latrobe Regional, Maroondah, Mt Eliza, Melbourne Extended Care Rehabilitation Service, Peter James, Queen Elizabeth Centre, Royal Talbot, St George’s, Sunshine and Williamstown. 2 Hospitals reporting acute are The Alfred, Angliss, Austin Hospital, Ballarat, Barwon Health, Bendigo, Box Hill, Dandenong, Frankston, Goulburn Valley, Latrobe Regional, Maroondah, Monash Medical Centre (Clayton & Moorabbin) , The Northern, Rosebud, Royal Melbourne, Sandringham, St Vincent’s, Western and Williamstown. There was no return from Sunshine for this census.

Source: Department of Human Services Bed Census. 3 How many bed days are spent waiting for residential aged care placements?

Figure 1.2 Number of bed days patients wait for residential aged care placement 1

Total bed days 30,000 25,253 25,000 22,596 20,612 Interim Care 10,723 20,000 Sub Acute Acute 8,136 10,879 15,000

10,000 9,400 7,740 10,901 5,000

3,076 3,977 3,629 0 Sep-02 Dec-02 Mar-03

1 Notes for Figure 1.1 apply. Source: Department of Human Services Bed Census. 4 2. Hospital Admitted Patient Activity

How many patients are admitted to hospital? Table 2.1 Admitted patients by individual hospital 1 2

March December March % Change March 2002 Hospital quarter 2002 quarter 2002 quarter 2003 to March 2003 Major metropolitan hospitals 3 Angliss Hospital 5,269 5,688 5,695 8.1% Austin Hospital 16,161 17,076 16,748 3.6% Box Hill Hospital 8,898 9,893 9,685 8.8% Dandenong Hospital 6,956 7,639 7,333 5.4% Frankston Hospital 9,897 10,776 10,560 6.7% Maroondah Hospital 4,739 5,126 4,949 4.4% Monash Medical Centre 18,766 20,277 19,644 4.7% Royal Melbourne Hospital 18,409 20,411 20,044 8.9% St Vincent's Hospital 10,362 11,845 10,915 5.3% Sunshine Hospital 6,897 6,846 6,823 -1.1% The Alfred 13,087 13,937 13,946 6.6% The Northern Hospital 6,365 7,165 6,909 8.5% Western Hospital 7,897 9,210 8,704 10.2% Other metropolitan hospitals Caulfield General Medical Centre 399 533 494 23.8% Mercy Public Hospital, East Melbourne 4,270 4,586 4,544 6.4% Peter MacCallum Cancer Institute 3,243 4,560 4,045 24.7% Royal Children's Hospital 6,895 8,092 7,060 2.4% Royal Women's Hospital 6,364 7,009 7,018 10.3% Sandringham & District Memorial Hospital 3,561 4,042 3,914 9.9% The Royal Victorian Eye and Ear Hospital 2,769 3,073 2,972 7.3% Other metropolitan hospitals 11,564 12,844 12,555 8.6% 1 Data refer to the number of WIES-fundable separations (ie. the number of patients that have been discharged from hospital). 2 2002/2003 data are provisional. 3 Major metropolitan hospitals contain the campuses listed in the Glossary.

5 Table 2.1 Admitted patients by individual hospital (continued)

March December March % Change March 2002 Hospital quarter 2002 quarter 2002 quarter 2003 to March 2003 Major regional hospitals Ballarat Health Services 5,903 6,054 5,785 -2.0% Barwon Health 4 12,289 12,904 13,194 7.4% Bendigo Health Care Group 5,327 6,162 5,982 12.3% Goulburn Valley Health 4,597 4,795 5,086 10.6% Latrobe Regional Hospital 5,523 5,757 5,332 -3.5% Other rural hospitals Central Gippsland Health Service 2,505 2,577 2,513 0.3% Northeast Health Wangaratta 2,925 3,289 3,132 7.1% South West Healthcare 3,341 3,711 3,548 6.2% Wimmera Health Care Group 2,108 2,400 2,156 2.3% Wodonga Regional Health Service 4,033 4,355 3,875 -3.9% Other rural hospitals 33,669 37,247 35,268 4.7% Grand total 4 254,988 279,879 270,428 6.1% 4 Data for the December 2002 and March 2003 quarters for Barwon Health were incomplete. Estimates have been included for comparative purposes.

Source: Victorian Admitted Episode Dataset (17 May 2003 update).

6 3. Access to Emergency Services

How many emergency patients are admitted to hospital? 1 2 3 4 Figure 3.1 Patients admitted to public hospitals requiring emergency care

Patients 100,000 97,396 92,871 94,697 96,007 89,940 89,262 92,304 90,000 87,672 82,511 All hospitals 80,000 Major metropolitan hospitals

Other hospitals 70,000

59,732 59,149 60,000 56,756 56,960 57,000 54,372 54,449 53,021 49,383 50,000

37,737 37,664 36,858 40,000 35,304 34,651 35,568 36,115 34,813 33,128

30,000 Mar-01 Jun-01 Sep-01 Dec-01 Mar-02 Jun-02 Sep-02 Dec-02 Mar-03

1 Major metropolitan hospitals contain the campuses listed in the Glossary. 2 Data refer to the number of WIES-fundable separations . 3 2002/2003 data are provisional. 4 Data for December 2002 and March 2003 quarters for Barwon Health were incomplete. Estimates have been included for comparative purposes.

Source: Victorian Admitted Episode Dataset (17 May 2003 update). 7 How many emergency patients are admitted to hospital?

Table 3.1 Emergency admissions 1 2 3

March December March % Change December 2002 % Change March 2002 Hospital quarter 2002 quarter 2002 quarter 2003 to March 2003 to March 2003 Major metropolitan hospitals

Angliss Hospital 2,042 2,215 2,165 -2.3% 6.0% Austin Hospital 4,173 5,422 5,204 -4.0% 24.7% Box Hill Hospital 4,127 4,736 4,777 0.9% 15.7% Dandenong Hospital 4,594 5,003 4,730 -5.5% 3.0% Frankston Hospital 5,367 5,864 5,697 -2.8% 6.1% Maroondah Hospital 2,928 3,161 2,894 -8.4% -1.2% Monash Medical Centre 6,169 6,142 6,194 0.8% 0.4% Royal Melbourne Hospital 5,693 5,962 5,691 -4.5% -0.0% St Vincent's Hospital 3,773 3,957 3,657 -7.6% -3.1% Sunshine Hospital 3,359 2,965 2,913 -1.8% -13.3% The Alfred 5,016 4,814 4,597 -4.5% -8.4% The Northern Hospital 3,389 3,722 3,662 -1.6% 8.1% Western Hospital 3,819 5,186 4,819 -7.1% 26.2% 4 Other hospitals total 34,813 36,858 35,304 -4.2% 1.4% Major hospitals total 54,449 59,149 57,000 -3.6% 4.7% Grand total4 89,262 96,007 92,304 -3.9% 3.4% 1 2002/2003 data are provisional. 2 Data exclude elective, maternity, newborn and statistical admissions. 3 Data refer to the number of WIES-fundable separations (ie. the number of patients that have been discharged from hospital). 4 Data for the December 2002 and March 2003 quarters for Barwon Health were incomplete. Estimates have been included for comparative purposes.

Source: Victorian Admitted Episode Dataset (17 May 2003 update).

8 How many patients stay for an extended period in the emergency department?

Figure 3.2 Patients staying in emergency departments for over 12 hours while waiting for a hospital bed 1 2

Patients 70,000 65,486 64,660 66,138 65,775 64,774 64,071 63,258 63,688 63,312 64,744 61,189 62,339 59,557 60,000 57,347 54,738

50,000

40,000 Total number of patients treated in emergency departments

30,000 Patients staying in emergency department for longer than 12 hours who were admitted to ward

20,000

10,000 2,675 2,732 2,839 2,901 2,602 1,664 1,844 1,595 2,027 2,207 1,692 1,704 1,487 1,400 1,470 0 Jan-02 Feb-02 Mar-02 Apr-02 May-02 Jun-02 Jul-02 Aug-02 Sep-02 Oct-02 Nov-02 Dec-02 Jan-03 Feb-03 Mar-03

1 The period of ‘stay’ is calculated from the time the patient arrives in the emergency department to the time when the patient leaves the emergency department. 2 2002/2003 data are provisional. Source : Victorian Emergency Minimum Dataset.

9 How many patients are treated in each hospital emergency department?

Table 3.2 Patients treated in hospital emergency departments, by Individual Hospitals 1 2

% Change March 2002 Hospital March quarter 2002 December quarter 2002 March quarter 2003 to March 2003 Major metropolitan hospitals Angliss Hospital 8,544 9,470 9,246 8.2% Austin Hospital 9,227 10,017 9,638 4.5% Box Hill Hospital 8,708 9,534 9,218 5.9% Dandenong Hospital 10,599 11,327 10,966 3.5% Frankston Hospital 9,928 11,276 11,246 13.3% Maroondah Hospital 7,686 8,781 8,318 8.2% Monash Medical Centre 12,328 12,963 12,177 -1.2% Royal Melbourne Hospital 11,982 11,649 11,369 -5.1% St Vincent's Hospital 7,788 8,065 7,814 0.3% Sunshine Hospital 12,037 13,521 13,081 8.7% The Alfred 9,387 10,068 9,900 5.5% The Northern Hospital 11,193 12,309 11,963 6.9% Western Hospital 7,596 8,596 7,988 5.2% Other metropolitan hospitals Royal Children's Hospital 12,223 13,592 11,741 -3.9% Major regional hospitals Ballarat Health Services 8,659 9,460 8,727 0.8% Barwon Health 9,962 10,190 9,853 -1.1% Bendigo Health Care Group 7,791 8,148 7,408 -4.9% Goulburn Valley Health 6,745 6,903 7,162 6.2% Latrobe Regional Hospital 6,686 6,906 6,615 -1.1% Total 179,069 192,775 184,430 3.0%

1 Data include all emergency department patients, that is, they include patients who are subsequently admitted to hospital and patients who are treated in the emergency department without being admitted to hospital. 2 2002/2003 data are provisional. Source: Victorian Emergency Minimum Dataset. 10 Table 3.3 Patients staying in selected public hospital emergency departments for over 12 hours while waiting for a hospital bed 1 2 3

March quarter 2002 December quarter 2002 March quarter 2003 Hospital Numbers Percentage Numbers Percentage Numbers Percentage Major metropolitan hospitals Angliss Hospital 86 6.9% 119 8.8% 85 7.1% Austin Hospital 296 10.2% 205 6.4% 129 4.2% Box Hill Hospital 349 14.2% 303 10.9% 282 10.1% Dandenong Hospital 572 25.0% 390 16.2% 325 13.7% Frankston Hospital 511 18.7% 378 13.1% 198 6.2% Maroondah Hospital 371 19.3% 415 20.8% 257 14.0% Monash Medical Centre 660 23.5% 776 26.4% 604 19.7% Royal Melbourne Hospital 698 22.2% 1,065 32.8% 929 29.4% St Vincent's Hospital 73 4.0% 140 7.1% 107 5.4% Sunshine Hospital 168 10.14% 34 2.7% 35 2.7% The Alfred 553 26.6% 517 20.5% 415 16.6% The Northern Hospital 297 14.9% 512 23.9% 293 12.7% Western Hospital 209 10.4% 241 9.6% 193 8.4% Other metropolitan hospitals Royal Children's Hospital 7 0.3% 16 0.6% 13 0.5% Major regional hospitals Ballarat Health Services 12 0.8% 36 2.2% 14 0.9% Barwon Health 149 3.9% 226 6.0% 307 8.1% Bendigo Health Care Group 62 3.4% 104 6.7% 119 8.2% Goulburn Valley Health 0 0.0% 0 0.0% 0 0.0% Latrobe Regional Hospital 30 2.9% 126 10.9% 52 4.6% Total 5,103 12.4% 5,603 12.8% 4,357 10.0% 1 The period of ‘stay’ is calculated from the time the patient arrives in the emergency department to the time when the patient leaves the emergency department. 2 Data represent the number of emergency department patients admitted to ward who spend more than 12 hours in the emergency department prior to being admitted as a proportion of all emergency department patients admitted to ward. 3 2002/2003 data are provisional.

Source: Victorian Emergency Minimum Dataset.

11 How many emergency department patients are treated within ideal time?

Figure 3.3 Emergency department achievement of ACEM waiting times by triage category 1 2 3

100%

90%

80%

70%

Proportion of category 1 60% patients treated immediately Proportion of category 2 patients treated within 10 minutes 50% Proportion of category 3 patients treated within 30 minutes

40% Jan-02 Feb-02 Mar-02 Apr-02 May-02 Jun-02 Jul-02 Aug-02 Sep-02 Oct-02 Nov-02 Dec-02 Jan-03 Feb-03 Mar-03

1 Waiting times are calculated as the time between presentation at the emergency department and commencement of treatment. The following Australasian College for Emergency Medicine (ACEM) patient categories and recommended treatment times are used: Category 1: Resuscitation case requiring immediate treatment, for example, major trauma, cardiac arrest, unconsciousness, shock. Category 2: Emergency case requiring treatment within 10 minutes, for example, severe trauma, chest pain, severe pain, severe breathing difficulty. Category 3: Urgent case requiring treatment within 30 minutes, for example, moderate trauma, infection, breathing difficulty. 2 The business rule for ‘treatment time’ changed in July 2002, now taking into account treatment by nurses. 3 2002/2003 data are provisional.

Source : Victorian Emergency Minimum Dataset. 12 How many emergency department patients are treated within ideal time?

Table 3.4 Patients treated in selected public hospital emergency departments in triage category 1, 2 or 3 within ACEM recommended waiting times: March quarter 2003 ¹ ²

Triage Category 1 Triage Category 2 Triage Category 3 Total Treated Total Treated in Total Treated in Hospital patients immediately patients 10 minutes patients 30 minutes Major metropolitan hospitals Angliss Hospital 17 100% 498 83% 2,216 82% Austin Hospital 102 100% 713 81% 3,326 75% Box Hill Hospital 111 100% 638 80% 3,305 60% Dandenong Hospital 82 100% 970 81% 2,954 64% Frankston Hospital 121 100% 2,421 98% 4,806 86% Maroondah Hospital 75 100% 634 85% 2,437 75% Monash Medical Centre 139 100% 1,465 83% 3,946 75% Royal Melbourne Hospital 157 100% 1,241 78% 3,498 77% St Vincent's Hospital 92 100% 648 76% 3,033 72% Sunshine Hospital 32 100% 659 94% 3,807 81% The Alfred 249 100% 1,207 81% 3,642 82% The Northern Hospital 97 100% 704 99% 3,243 96% Western Hospital 91 100% 806 95% 2,600 92% Other metropolitan hospitals Royal Children's Hospital 29 100% 268 85% 2,872 76% Major regional hospitals Ballarat Health Services 41 100% 273 85% 1,594 90% Barwon Health 45 100% 777 66% 2,545 59% Bendigo Health Care Group 30 100% 474 100% 2,046 100% Goulburn Valley Health 21 100% 377 86% 1,691 91% Latrobe Regional Hospital 59 100% 380 88% 1,540 90% Total 1,590 100% 15,153 86% 55,101 79% 1 Australasian College for Emergency Medicine (ACEM). The business rule for 'treatment time' changed in July 2002/03, now taking into account treatment from nurses. 2 2002/2003 data are provisional.

Source: Victorian Emergency Minimum Dataset.

13 How often do hospital emergency departments go on ‘bypass’? Figure 3.4 Periods of ambulance bypass of public hospitals 1 2

Bypass Incidents 1,200

900

580 600 416

218 300 189 113

0 Mar-02 Jun-02 Sep-02 Dec-02 Mar-03 Quarters

1 Hospital emergency departments can request to go on ambulance bypass when the emergency department has reached maximum capacity and the treatment of patients already in the emergency department could be significantly compromised with the arrival, by ambulance, of further patients. Each individual period of ambulance bypass is for two hours or less. 2 Bypass policy allows for critically ill or injured patients to be taken to the nearest hospital emergency department regardless of bypass status. Source: Metropolitan Ambulance Service.

14 How often do hospital emergency departments go on 'bypass'?

Table 3.5 Periods of ambulance bypass, by Individual Hospital 1 2

Mar-02 Jun-02 Sep-02 Dec-02 Mar-03 Hospital Qtr Qtr Qtr Qtr Qtr Major metropolitan hospitals

Angliss Hospital 5 3 7 2 6 Austin Hospital 1 23 33 9 6 Box Hill Hospital 9 17 17 6 8 Dandenong Hospital 11 27 41 12 7 Frankston Hospital 40 42 39 13 14 Maroondah Hospital 15 11 26 11 3 Monash Medical Centre 43 106 104 39 13 Royal Melbourne Hospital 5 60 116 74 30 St Vincent's Hospital 3 17 27 1 0 Sunshine Hospital 4 28 21 7 3 The Alfred 24 15 31 2 2 The Northern Hospital 5 21 38 11 3 Western Hospital 24 46 80 31 18 Total 189 416 580 218 113

2 Metropolitan Ambulance Service (MAS) response times are now being reported in MAS Response Report: A Quarterly Statistical Review of MAS, Melbourne. Copies of the Response Report can be obtained from MAS, Corporate Planning and Corporate Communications Unit, phone (03) 9840 3648.

Source: Metropolitan Ambulance Service.

4. Access to Critical Care Services

How many hospital beds are available for patients who need intensive care? Table 4.1 Average number of public hospital intensive care beds available and open at 9.00a.m., by Month 1 2

Jan-02 Feb-02 Mar-02 Apr-02 May-02 Jun-02 Jul-02 Aug-02 Sep-02 Oct-02 Nov-02 Dec-02 Jan-03 Feb-03 Mar-03 Available 3 4.4 5.9 6.3 5.1 4.0 3.1 1.9 2.0 1.5 3.1 3.8 3.7 5.2 4.7 4.3 Total Open 4 96.7 95.0 96.3 95.0 97.9 97.9 99.7 93.8 100.1 98.6 98.8 96.7 95.0 103.2 103.1 Available (incl Barwon Health) 5 n.a. n.a. n.a. n.a. n.a. n.a. 2.0 2.0 1.6 3.7 4.5 4.2 5.9 5.6 4.9 Total Open ICU (incl Barwon Health) 5 n.a. n.a. n.a. n.a. n.a. n.a. 106.7 101.0 106.8 105.9 105.3 103.3 101.4 110.2 110.8 Total Open ICU & HDU (incl Barwon Health) 6 n.a. n.a. n.a. n.a. n.a. n.a. 131.6 126.5 132.4 129.4 134.4 130.5 129 135.5 138.2

1 Based upon hospital census taken at 9.00a.m. daily.

2 The data in this table represents an average for each month and varies from Table 4.3 which gives averages for the quarter.

3 Available beds are unoccupied beds which are staffed, functional and available to receive new patients.

4 Total open beds are all functioning and staffed beds, regardless of whether they are occupied.

5 Change in counting from July 2002 to include Barwon Health intensive care.

6 Change in counting from July 2002 to include all unit beds ie. Intensive Care and Stepdown Beds and Barwon Health.

Source: Office of the Coordinator of Emergency and Critical Care Services.

How many hospital beds are available for patients who need coronary care? Table 4.2 Average number of public hospital coronary care beds available and open at 9.00a.m., by Month 1

Jan-02 Feb-02 Mar-02 Apr-02 May-02 Jun-02 Jul-02 Aug-02 Sep-02 Oct-02 Nov-02 Dec-02 Jan-03 Feb-03 Mar-03 Available 7.7 8.1 10.2 7.8 5.1 5.2 4.5 3.4 3.6 4.9 7.3 4.7 7.9 8.5 8.4 Total Open 71.7 73.0 74.6 72.9 74.4 72.5 66.4 68.0 67.7 66.1 68.2 69.0 70.3 70.9 72.3 Available (incl Barwon Health) n.a. n.a. n.a. n.a. n.a. n.a. 5.3 3.9 3.9 5.6 7.9 5.2 8.8 9.3 9.2 Total Open (incl Barwon Health) n.a. n.a. n.a. n.a. n.a. n.a. 72.4 74.0 73.7 72.1 74.2 75.0 76.3 76.9 78.3 1 Notes under Table 4.1 apply.

Source: Office of the Coordinator of Emergency and Critical Care Services.

17 How many hospital beds are available for patients who need intensive care?

Table 4.3 Average number of public hospital intensive care beds available and open at 9.00a.m., by Hospital: March quarter 2003 ¹

Total Open Total Open Hospital Available 2 ICU 3 ICU & HDU 3 Major metropolitan hospitals Angliss Hospital n.a. n.a. n.a. Austin Hospital 0.0 11.5 12.6 Box Hill Hospital 0.2 5.0 7.1 Dandenong Hospital 0.3 7.0 6.9 Frankston Hospital 0.6 5.9 7.9 Maroondah Hospital 0.8 3.3 5.8 Monash Medical Centre 0.9 11.7 12.0 Royal Melbourne Hospital 0.2 16.0 20.5 St Vincent's Hospital 0.4 8.9 9.0 Sunshine Hospital n.a. n.a. n.a. The Alfred 0.2 21.3 27.1 The Northern Hospital 0.2 4.6 7.4 Western Hospital 0.9 5.3 8.7 Other hospitals Barwon Health 0.7 7.0 13.2 Total 4 5.5 107.5 138.2 1 Based upon hospital census taken at 9.00a.m. daily. 2 Available beds are unoccupied beds which are staffed, functional and available to receive new patients. 3 Total open beds are all functioning and staffed beds, regardless of whether they are occupied. 4 The data in this table represents an average for the quarter and varies from tables 4.1 and 4.2 which are averages for each month.

Source: Office of the Coordinator of Emergency and Critical Care Services.

18 5. Access To Elective Surgery

How many people are on hospital waiting lists for elective surgery? Figure 5.1 Waiting list by urgency 1 2 3

50,000

45,000 40,695 37,550 37,642 40,000

35,000

30,000 25,366 Total waiting list 23,514 22,973 25,000 Non-urgent cases Patients 20,000 Semi-urgent cases

15,000 Urgent cases

10,000 14,695 13,652 13,942 5,000

0 634 384 727 At 31 March 2002 At 31 December 2002 At 31 March 2003

1 Waiting list numbers include all patients booked and waiting for elective surgery , in line with national definitions. 2 The waiting list patient categories are: • Urgent cases (waiting list category 1): Admission within 30 days desirable for a condition that has the potential to deteriorate quickly to the point that it may become an emergency. • Semi-urgent cases (waiting list category 2): Admission within 90 days desirable for a condition causing some pain, dysfunction or disability but which is not likely to deteriorate quickly or become an emergency. • Non-urgent cases (waiting list category 3): Admission at some time in the future acceptable for a condition causing minimal or no pain, dysfunction or disability which is very unlikely to deteriorate quickly and which does not have the potential to become an emergency. 3 2002/2003 data are provisional.

Source: Elective Surgery Information System.

19 How many people are on hospital waiting lists for elective surgery?

Table 5.1 Waiting lists by Urgency, by Individual Hospital 1 2

Urgent cases Semi-urgent cases Non-urgent cases

Hospital 31 Mar 2002 31 Dec 2002 31 Mar 2003 31 Mar 2002 31 Dec 2002 31 Mar 2003 31 Mar 2002 31 Dec 2002 31 Mar 2003 Major metropolitan hospitals Angliss Hospital 23 6 20 197 154 188 233 165 121 Austin Hospital 35 26 70 1,457 1,072 1,000 1,174 1,190 1,230 Box Hill Hospital 41 11 47 512 566 675 696 764 864 Dandenong Hospital 29 19 40 905 1,098 1,219 2,181 2,046 2,063 Frankston Hospital 83 54 57 2,248 2,122 2,015 1,241 949 902 Maroondah Hospital 15 3 22 169 127 98 722 1,065 919 Monash Medical Centre 65 45 88 1,273 1,380 1,285 2,946 2,530 2,493 Royal Melbourne Hospital 36 31 32 948 839 1,004 1,727 1,541 1,624 St Vincent's Hospital 43 21 42 908 742 758 774 859 825 Sunshine Hospital 5 4 8 180 165 197 441 567 683 The Alfred 72 48 82 1,442 1,063 939 1,264 1,018 844 The Northern Hospital 33 23 22 736 965 964 1,841 1,692 1,809 Western Hospital 22 6 35 610 693 660 824 782 787 Other metropolitan hospitals Royal Children's Hospital 17 13 24 186 138 224 1,242 1,419 1,416 Royal Women's Hospital 9 2 6 198 178 155 240 160 155 Sandringham & District Memorial Hospital 5 6 12 181 128 178 388 370 337 The Royal Victorian Eye and Ear Hospital 12 8 19 647 223 385 2,342 1,670 1,321

1 Waiting list numbers include all patients booked and waiting for elective surgery, in line with national definitions. 2 2002/2003 data are provisional.

20 Table 5.1 Waiting lists by Urgency, by Individual Hospital (continued)

Urgent cases Semi-urgent cases Non-urgent cases

Hospital 31 Mar 2002 31 Dec 2002 31 Mar 2003 31 Mar 2002 31 Dec 2002 31 Mar 2003 31 Mar 2002 31 Dec 2002 31 Mar 2003 Major regional hospitals Ballarat Health Services 3 2 6 267 255 234 1,171 993 928 Barwon Health 20 6 11 656 658 679 1,834 1,605 1,436 Bendigo Health Care Group 28 20 32 390 396 408 739 685 669 Goulburn Valley Health 19 17 19 195 307 267 154 207 204 Latrobe Regional Hospital 7 3 16 117 130 164 517 479 508 Other rural hospitals Northeast Health Wangaratta 1 1 2 113 87 80 272 372 389 West Gippsland Hospital 11 9 15 160 166 166 403 386 446 Total 634 384 727 14,695 13,652 13,942 25,366 23,514 22,973

Source: Elective Surgery Information System.

21 What is the throughput of people waiting for elective surgery?

Table 5.2 Admissions and cancellations, by Individual Hospital 1 2

Patients on Waiting Lists Admissions from Waiting Lists Patients Cancelled from Waiting Lists

During the Quarter During the Quarter Hospital at 31 Mar 2002 at 31 Dec 2002 at 31 Mar 2003 Mar-02 Dec-02 Mar-03 Mar-02 Dec-02 Mar-03 Major metropolitan hospitals Angliss Hospital 453 325 329 544 757 727 82 157 75 Austin Hospital 2,666 2,288 2,300 1,715 1,906 1,942 299 379 373 Box Hill Hospital 1,249 1,341 1,586 1,115 1,192 1,128 241 183 282 Dandenong Hospital 3,115 3,163 3,322 982 1,238 1,366 245 932 265 Frankston Hospital 3,572 3,125 2,974 1,231 1,487 1,499 313 429 323 Maroondah Hospital 906 1,195 1,039 766 720 752 176 141 211 Monash Medical Centre 4,284 3,955 3,866 1,752 1,948 1,910 408 844 334 Royal Melbourne Hospital 2,711 2,411 2,660 1,614 1,603 1,400 437 387 379 St Vincent's Hospital 1,725 1,622 1,625 1,021 1,144 1,023 220 156 231 Sunshine Hospital 626 736 888 1,001 1,045 1,086 202 186 106 The Alfred 2,778 2,129 1,865 1,050 1,347 1,329 504 284 453 The Northern Hospital 2,610 2,680 2,795 1,069 1,290 1,224 683 433 180 Western Hospital 1,456 1,481 1,482 1,129 940 956 189 199 206 Other metropolitan hospitals Royal Children's Hospital 1,445 1,570 1,664 2,067 2,598 2,256 211 149 167 Royal Women's Hospital 447 340 316 712 705 734 166 204 134 Sandringham & District Memorial Hospital 574 504 527 579 508 483 122 59 122 The Royal Victorian Eye and Ear Hospital 3,001 1,901 1,725 2,337 2,586 2,553 425 313 259

1 Waiting list numbers include all patients booked and waiting for elective surgery, in line with national definitions. 2 2002/2003 data are provisional.

22 Table 5.2 Admissions and cancellations, by Individual Hospital (continued)

Patients on Waiting Lists Admissions from Waiting Lists Patients Cancelled from Waiting Lists

During the Quarter During the Quarter Hospital at 31 Mar 2002 at 31 Dec 2002 at 31 Mar 2003 Mar-02 Dec-02 Mar-03 Mar-02 Dec-02 Mar-03 Major regional hospitals Ballarat Health Services 1,441 1,250 1,168 607 664 555 80 198 93 Barwon Health 2,510 2,269 2,126 967 1,290 1,187 508 204 186 Bendigo Health Care Group 1,157 1,101 1,109 1,051 1,118 1,060 120 94 134 Goulburn Valley Health 368 531 490 536 636 695 79 133 91 Latrobe Regional Hospital 641 612 688 969 1,001 802 86 51 71 Other rural hospitals Northeast Health Wangaratta 386 460 471 482 490 490 37 53 36 West Gippsland Hospital 574 561 627 478 522 522 65 49 52 Total 40,695 37,550 37,642 25,774 28,735 27,679 5,898 6,217 4,763

Source: Elective Surgery Information System.

23 How many people are on hospital waiting lists for longer than the ideal time?

Table 5.3 People on elective surgery waiting lists for longer than ideal time, by Individual Hospital 1 2

Urgent cases waiting over 30 days Semi-urgent cases waiting over 90 days

Hospital 31 Mar 2002 31 Dec 2002 31 Mar 2003 31 Mar 2002 31 Dec 2002 31 Mar 2003 Major metropolitan hospitals Angliss Hospital 0 0 0 0 0 0 Austin Hospital 0 0 0 720 430 395 Box Hill Hospital 0 0 0 70 124 97 Dandenong Hospital 0 0 0 567 695 757 Frankston Hospital 0 0 0 1,447 1,398 1,288 Maroondah Hospital 0 0 0 19 25 7 Monash Medical Centre 0 0 0 568 682 665 Royal Melbourne Hospital 0 0 0 473 367 426 St Vincent's Hospital 0 0 0 446 265 286 Sunshine Hospital 0 0 0 17 20 11 The Alfred 0 0 0 1,012 584 493 The Northern Hospital 0 0 0 242 414 386 Western Hospital 0 0 0 261 289 312 Other metropolitan hospitals Royal Children's Hospital 0 0 0 0 0 0 Royal Women's Hospital 0 0 0 0 1 0 Sandringham & District Memorial Hospital 0 0 0 46 13 19 The Royal Victorian Eye and Ear Hospital 0 0 0 195 45 31

1 Waiting list numbers include all patients booked and waiting for elective surgery, in line with national definitions. 2 2002/2003 data are provisional.

24 Table 5.3 People on elective surgery waiting lists for longer than ideal time, by Individual Hospital (continued)

Urgent cases waiting over 30 days Semi-urgent cases waiting over 90 days

Hospital 31 Mar 2002 31 Dec 2002 31 Mar 2003 31 Mar 2002 31 Dec 2002 31 Mar 2003 Major regional hospitals Ballarat Health Services 0 0 0 103 90 85 Barwon Health 0 0 0 322 323 310 Bendigo Health Care Group 0 0 0 187 195 215 Goulburn Valley Health 0 0 0 13 83 43 Latrobe Regional Hospital 0 0 0 8 2 3 Other rural hospitals Northeast Health Wangaratta 0 0 0 22 6 3 West Gippsland Hospital 0 0 0 43 35 36 Total 0 0 0 6,781 6,086 5,868

Source: Elective Surgery Information System.

25 What percentage of patients are admitted within clinically ideal times?

Figure 5.2 Percentage of patients from elective surgery waiting lists who were admitted within the ideal time, by Urgency 1

100%

90%

80%

70% Urgent cases Semi-urgent cases 60%

50%

40% Dec-01 Mar-02 Jun-02 Sep-02 Dec-02 Mar-03

Quarters

1 2002/2003 data are provisional.

Source: Elective Surgery Information System.

26 What percentage of patients are admitted within clinically ideal times?

Table 5.4 Percentage of people from elective surgery waiting lists who were admitted within the ideal time, by Urgency, by Individual Hospital 1

Urgent cases admitted within 30 days during the quarter Semi-urgent cases admitted within 90 days during the quarter December 2002 March 2003 December 2002 March 2003 Hospital Number Percentage Number Percentage Number Percentage Number Percentage Major metropolitan hospitals Angliss Hospital 93 100.00% 78 100.00% 431 99.77% 385 99.48% Austin Hospital 599 100.00% 571 100.00% 642 70.24% 634 68.91% Box Hill Hospital 308 100.00% 278 100.00% 556 82.74% 529 78.25% Dandenong Hospital 295 100.00% 296 100.00% 249 71.55% 206 54.79% Frankston Hospital 327 100.00% 300 100.00% 479 57.09% 432 48.92% Maroondah Hospital 169 100.00% 203 100.00% 249 87.68% 199 86.15% Monash Medical Centre 657 100.00% 596 100.00% 546 69.03% 545 62.36% Royal Melbourne Hospital 705 100.00% 647 100.00% 440 74.83% 335 64.05% St Vincent's Hospital 268 100.00% 254 100.00% 627 83.71% 492 73.00% Sunshine Hospital 61 100.00% 53 100.00% 312 92.31% 291 86.61% The Alfred 552 100.00% 505 100.00% 386 60.69% 388 60.25% The Northern Hospital 306 100.00% 214 100.00% 505 69.08% 467 62.18% Western Hospital 163 100.00% 199 100.00% 465 80.87% 446 75.85% Other metropolitan hospitals Royal Children's Hospital 387 100.00% 382 100.00% 531 100.00% 400 100.00% Royal Women's Hospital 188 100.00% 156 100.00% 370 99.73% 452 99.12% Sandringham & District Memorial Hospital 106 100.00% 106 100.00% 220 89.80% 207 88.84% The Royal Victorian Eye and Ear Hospital 135 100.00% 115 100.00% 1,251 94.77% 1,263 96.19%

1 2002/2003 data are provisional.

27 Table 5.4 Percentage of people from elective surgery waiting lists who were admitted within the ideal time, by Urgency, by Individual Hospital (continued)

Source: Elective Surgery Information System.

28 What is the admission source of total hospital activity? Figure 5.3 Separations by admission type: March quarter 2003 1 2 3 7

Emergency Admissions 34% 46% 92,304

Other elective admissions 4 124,177 10% 10%

Other admissions6 Elective admissions 26,268 from the waiting list 5 27,679

1 Percentages may not add to 100% due to rounding. 2 2002/2003 data are provisional. 3 Data refer to the number of WIES-fundable separations only. 4 Excludes patients admitted from the elective surgery waiting list. 5 Patients admitted from the elective surgery waiting list during the quarter (ESIS). 6 Includes maternity, newborn and statistical (change in patient care type) admissions. 7 Data for March 2003 quarter for Barwon Health are not currently available. Estimates have been included for comparative purposes.

Source: Victorian Admitted Episode Dataset (17 May 2003 update). Elective Surgery Information System. 29

6. Private Health Insurance

How many Victorians have private health insurance hospital cover?

Figure 6.1 Health insurance status of Victorians 1 2 3

Without private health insurance hospital cover 56.8% of 56.5% of 55.8% of population 3,500,000 population With private health insurance population without private without private hospital cover without private health insurance 44.2% of health insurance health insurance 43.5% of hospital cover 43.2% of 3,000,000 population with hospital cover hospital cover population with population with private health private health private health insurance 2,500,000 2,776,000 insurance 2,799,000 insurance 2,714,000 hospital cover hospital cover hospital cover

2,000,000 2,150,000 2,137,000 2,129,000

1,500,000

1,000,000

500,000

0 At 31 March 2002 At 31 December 2002 At 31 March 2003

1 Data are for all people covered by insurance, that is, contributors, partners and dependants. 2 Data for current and previous quarters are provisional. 3 Statistics reflect total persons covered by any level of hospital private health insurance. Source: Private Health Insurance Administration Council (30 May 2003). 31

7. Glossary

What do the terms used in this report mean?

Admitted Patient Intensive Care Someone who is an inpatient in a hospital. Sameday patients who are admitted for less than A hospital unit with specialised staff and equipment to provide continuous care for critically 24 hours are also counted as inpatients but people who attend hospital for outpatient clinics ill, injured or post-operative patients. are not. Major Metropolitan Hospitals Cancellation Include Angliss Hospital, Austin Hospital (Austin Hospital & Heidelberg Repatriation The request for elective surgery has been withdrawn and the patient is removed from this Hospital), Box Hill Hospital, Dandenong Hospital, Frankston Hospital, Maroondah Hospital, hospital's Waiting List without admission for the awaited procedure. This can occur for Monash Medical Centre (Clayton Campus & Moorabbin Campus), Royal Melbourne Hospital, clinical reasons, transfer of the patient to another hospital, or at the request of the patient. St Vincent’s Hospital, Sunshine Hospital, The Alfred, The Northern Hospital and Western Hospital. Casemix Funded A system of funding hospitals according to the actual number and type of services that they Separation provide. Casemix funding was introduced for most Victorian public hospitals in July 1993. When an admitted patient leaves a hospital. This is the technical way of counting the number of admitted patients treated by a hospital. Coronary Care A hospital unit with specialised staff and equipment to care for patients with heart disease. Step Down Bed Hospital beds with specialised staff and equipment to care for patients who no longer need Elective Admission coronary or intensive care but are not yet ready to move to a general hospital ward. A planned admission to hospital. Emergency admissions and transfers from other hospitals are not counted as elective admissions. Transfer When an inpatient is moved from one hospital to another. This might be in order to obtain a Elective Surgery specialised treatment not available at the first hospital or because of the patient’s Planned surgery that is not an emergency requiring hospital admission within 24 hours. preferences. Emergency Admission Waiting List Hospital An unplanned admission to hospital due to unexpected illness or injury that requires urgent A major public hospital that performs elective surgery for public patients and uses a waiting care. list to properly keep track of people who require elective surgery. Emergency Department A hospital department that specialises in providing emergency care for people who are in need of urgent care (ambulance cases for example) and people who choose to seek treatment in an emergency department.